​Individual funding requests for medical treatments that are not available in Lewisham

 

Individual funding request

 An individualf funding request (IFR) is a request to fund, for an individual patient, an intervention or treatment that falls outside existing contracts and commissioning arrangements. This request must be made by an NHS funded clinician (GP, consultant or equivalent autonomous practitioner) who is responsible for overseeing the requested treatment.

 Funding requests can be made on the basis of exceptionality – where the patient is suffering from a presenting medical condition for which the CCG has a policy but where the requested treatment has not been agreed to be funded under the policy or rarity and the patient would gain more clinical benefit from the treatment from other with the same diagnosis, or rarity – where a patient has a very rare clinical condition and no commissioning policy exists because the low probability of the condition occurring among the CCG's population means that an explicit policy is not warranted.

 An individual funding request can be made by the clinician treating you if they believe that because your clinical circumstances are exceptional, you may receive benefit from a treatment or service that isn't routinely offered by the NHS.

When can an individual funding request be made?

An individual funding request can be made for a treatment that is not routinely offered by the NHS:

•         When your clinician believes that your clinical circumstances are clearly different to other patients with the same condition, and:

•         When there is a reason why you would respond differently to other patients - and therefore gain more clinical benefit from the treatment.

How do I apply for an IFR?

 An NHS clinician, such as your GP or specialist consultant (NHS) will need to make an application online on your behalf via a web based portal called Blueteq.  Applications are not accepted from individuals.

What is the process?

The application is made online.  For most procedures there is a criteria that needs to be met.  If your circumstances does not meet with the criteria, then the clinician doing your application will need to provide evidence that your circumstances are clinically exceptional or rare. It is the responsibility of the clinical applicant to submit all the necessary information and to make the case for exceptionality or rarity. 

Once the application is completed, a triage group will review the application and all the information submitted. This is done weekly, to ensure that funding requests are responded to as quickly as possible. The role of triage is to establish if the application makes a possible case for clinical exceptionality or rarity. If so the case will be forwarded to the IFR panel for consideration for funding.

Applications where a case of exceptionality or rarity have not been demonstrated will be triaged out, closed and will not progress to the IFR panel for funding consideration. The applicant will be informed of the reasons for this decision.

It is the clinical applicant's responsibility to inform the patient of the outcome of the funding application and, where appropriate, to discuss next steps. 

The IFR application is then discussed at a monthly IFR panel meeting where the final decision as to whether to agree to the request is decided.  The decision will then be relayed to the clinician who submitted the application, and they will then inform you of the outcome.